A Therapist’s Guide to Better Care For Queer Patients of Color

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Therapist Jor-El Caraballo weighs in on what steps providers can take to affirm and connect with LGBTQ patients of color.

For individuals who belong to more than one minority group, it can be extremely challenging to find a mental healthcare provider who truly understands and can speak to your experience.

We sat down with Lighthouse therapist Jor-El Caraballo — who specializes in working with LGBTQ patients of color — to discuss what steps healthcare professionals of all backgrounds can do to improve care for the community.

1. Engage in Self Reflection

“Something that I frequently hear from my LGBTQ patients of color is, ‘I’ve had therapy before, but I didn’t feel comfortable being in a therapeutic space with a provider who didn’t share my identity,’” says Caraballo. “Either the therapists themselves didn’t identify as LGBTQ, or they didn’t understand the lived experience of an LGBTQ person or visible person of color.”

While it can certainly be beneficial for providers to possess a real-life understanding of their patients’ experiences, it’s still possible to provide competent, affirming care for patients with whom you may not share a racial identity or sexual orientation.

For that to work, providers must engage in intentional, ongoing self-reflection. Examine ingrained belief systems and assumptions, and work to deconstruct them through continued education and peer interaction.

“I recommend reading the book Overcoming Our Racism,” says Caraballo. “It’s designed to help readers understand and combat racism in themselves, and explores ideas about prejudice, privilege, and microaggressions.”

2. Call It Like It Is

Whenever a mental healthcare provider is working with a patient who is either queer, a person or color, or both, the provider must create space to talk about homophobia, transphobia, racism, and other discrimination that patient may encounter.

While many therapists tend to focus on interior, individual frameworks, it’s important that providers give a name to acts of discrimination and facilitate dialogue surrounding them.

“For people who have always been told to question their lived experiences, it can be affirming and powerful for a provider to say, ‘Yes, you were probably followed around in that store because of your skin color or your non-normative appearance,’” says Caraballo.

3. Be Intentional With Your Language

Language is a powerful tool that can quickly alienate or affirm a patient. All healthcare professionals — regardless of their specialty — should pay close attention to the language they use in reference to patients.

“Specifically when talking to queer folks of color, it’s important for therapists to understand that there’s a whole other language out there,” says Caraballo. “For example, some black people don’t identify as gay because they see ‘gay’ as a historically white word and white identity.”

A patient might instead identify as “MSM” (man who has sex with men) or as “SGL” (same gender loving). “It’s so important to give clients space to use the language they feel most comfortable with, and to research what other terms are out there that you might not be familiar with,” says Caraballo.

Clinicians should be equally cognizant of the traditionally white or mainstream narratives they may unintentionally impose on clients. “The coming out process can be different for some queer people of color,” says Caraballo. While there may be certain models of what providers think coming out should look like, the experience can vary depending on a person’s community and cultural background. “There are many ways in which people may live and express their gender or sexual identities,” says Caraballo. “It’s important for providers to broaden the scope of their questions and to avoid assumptions that, just because someone is not coming out in a traditional way, it means that person has internalized self-hatred.”

4. Work To Understand Overlapping Minority Stressors

Considering the current social and political climate — in which issues like immigration, racial intolerance, and LGBTQ rights are all topics of hostile debate — it’s important to acknowledge and understand the unique ways that double and triple minorities may be struggling.

“Privilege plays a role even between minority groups. You can be a brown queer person and enter a queer bar, but feel isolated because you’re surrounded by white normalcy,” says Caraballo. “Often, this manifests in microaggressions where, for instance, a bartender inadvertently prioritizes other white people.”

Even if you belong one minority group, acknowledge that you may not have the same lived experiences as a patient who belongs to another.

Building Communities and Seeking Safe Spaces

Caraballo recommends that queer people of color ask potential therapists about their past experience working with other LGBTQ people of color. The language that the therapist uses in their response can serve as a litmus test for how knowledgeable and sensitive they are.

“Language starts the moment that you begin interacting with a potential client,” says Caraballo. “Therapists seeking to be more competent about race and ethnicity should inquire about both, rather that assuming that a person identifies a certain way based on their skin color.” Additionally, Caraballo notes that if a therapist uses the term “transgendered” (as opposed to transgender) or “homosexual,” they immediately communicate a lack of knowledge that may read as discomfort or prejudice toward a queer person of color.

Outside of therapy, there are many excellent support groups, coalitions, and organizations designed to empower, connect, and mobilize LGBTQ people of color. Click here or here to learn more about how you can get involved with other members of the community.

To find an LGBTQ-affirming mental health specialist near you, head over to lighthouse.lgbt.